T he International Classification of Diseases for Oncology (ICD-O) isa collaborative undertaking of the International Agency for Research on Cancer (IARC) and the National Cancer Institute (NCI) in the U.S., under the aegis of the World Health Organization (WHO). The first edition of the ICD-O (published in 1976) is an extension of the second chapter ("Neoplasms") of the ninth revision of the International Classification of Diseases (ICD-9) and, in addition to the ICD-9 codes (which describe anatomic sites of tumors), also allows the coding of histology. The second edition of the ICD-O (published in 1990) 1 similarly extends the second chapter of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10).The ICD-O codes tumors based on topography (anatomic location), morphology (histology), and behavior (malignant, benign, in situ, of uncertain behavior, or metastatic) but not staging. The topography codes are listed as C00.0 to C80.9. The morphology codes (M) in the second edition were modified in particular for non-Hodgkin lymphoma to accommodate the Working Formulation for this group of diseases. The morphology codes range from 8000/0 to 9989/1, in which the first 4 digits of the code indicate the specific histology and the 5th digit (after the slash) is the behavior code. A separate 1-digit code identifies histologic grading (differentiation) and also is used for T cell and B cell categorization in leukemias and lymphomas. Accordingly, the full description of a neoplasm in the ICD-O is a 10-item alpha numeric: 4 for topography, 4 for morphology, 1 for behavior, and 1 for histologic grade. As an example, acute lymphoblastic leukemia of B precursor type is coded as C42.1 9821/3 6.Although the ICD-O system generally is applicable to cancers diagnosed in childhood, it is recognized that morphology takes precedence over topography in classifying neoplasms occurring in children. For example, rhabdomyosarcoma occurs nearly everywhere in 1425